Abstract
CD19-targeted chimeric antigen receptor (CAR) T cells have provided a breakthrough in the treatment of patients with relapsed and/or refractory large B cell lymphoma (LBCL). Currently, three CD19-targeted CAR T cell products are approved by the FDA and various other regulators for the treatment of patients with LBCL: axicabtagene ciloleucel, tisagenlecleucel and lisocabtagene maraleucel. Response rates following infusion of these CD19-targeted CAR T cells have been promising; however, approximately half of treated patients show relapse within 2 years. Furthermore, receiving these agents can be associated with serious toxicities, including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. In this Review, we summarize the factors associated with the efficacy, including response and survival outcomes, and toxicity of CD19-targeted CAR T cells in pivotal clinical trials and large real-world datasets describing the outcomes of patients with LBCL who received treatment with these products.
Overview
- The review summarizes the efficacy and toxicity of CD19-targeted chimeric antigen receptor (CAR) T cells in clinical trials and real-world datasets for patients with relapsed and/or refractory large B cell lymphoma (LBCL).
- The review focuses on the three FDA-approved CD19-targeted CAR T cell products: axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel.
- The review aims to identify factors associated with the efficacy and toxicity of CD19-targeted CAR T cells in patients with LBCL.
Comparative Analysis & Findings
- Pivotal clinical trials and large real-world datasets show promising response rates following infusion of CD19-targeted CAR T cells, but approximately half of treated patients show relapse within 2 years.
- Receiving CD19-targeted CAR T cells can be associated with serious toxicities, including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome.
- The review highlights the importance of identifying factors that contribute to the efficacy and toxicity of CD19-targeted CAR T cells to improve treatment outcomes for patients with LBCL.
Implications and Future Directions
- The review emphasizes the need for further research to identify factors associated with the efficacy and toxicity of CD19-targeted CAR T cells to improve treatment outcomes for patients with LBCL.
- Future studies should evaluate the role of novel CAR T cell therapies and combination therapies to enhance the treatment of LBCL.
- The review highlights the importance of developing strategies to prevent or manage toxicities associated with CD19-targeted CAR T cells to improve patient outcomes and quality of life.